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Thyroid Disease and Diabetes

As part of the endocrine system, your thyroid plays a vital role in helping to regulate and maintain balance in your blood glucose level. Thyroid disease is more common in people with diabetes. The reverse is also true: diabetes is more common in people with thyroid disease. Let’s explore the connection between these two endocrine conditions.

Glucose is a form of sugar that provides energy. You get glucose from food, and your liver also makes and stores glucose. Your pancreas produces insulin and the job of insulin is to move glucose into your cells, lowering your blood sugar level. The term diabetes refers to a dysfunction in the production or use of insulin in the body.

Type 1 diabetes

In type 1 diabetes — also known as juvenile diabetes — your immune system attacks the cells in your pancreas that produce insulin, making you unable to produce insulin. The cause of the immune attack is not specifically known, but experts believe that genetics, viruses, and environmental exposures each play a role.

The risk factors for type 1 diabetes include:

gender: females are at higher risk than males

having a parent, sibling, or child with type 1 diabetes

having another autoimmune disease yourself, including Hashimoto’s thyroiditis and Graves’ disease

having a parent, sibling, or child with another autoimmune disease

being geographically located further away from the equator

Type 1 diabetes is most often diagnosed in children or teenagers. There is, however, an increase in the diagnosis of type 1 diabetes in adults. This is known as Latent Autoimmune Diabetes in Adults, or LADA.

African-Americans, Hispanics, Native Americans, and Asian-Americans are also at higher risk of type 2 diabetes compared to Caucasians.

Type 2 diabetes is treated with a variety of approaches that can include:

oral or injectable medications to make your body more sensitive to insulin

changes to your diet, such as lower-carbohydrate, higher-fiber diet

increased exercise

Less commonly, some people with type 2 diabetes become insulin-dependent.

Thyroid disease and diabetes

Thyroid disease and diabetes are related. According to the Diabetes Council, around 6.6 percent of the population has type 1 or type 2 diabetes. Diabetics of both types are more likely to have a thyroid condition. For example:

If you have type 2 diabetes, you have a 12 percent chance of having or developing a thyroid condition. The American Diabetes Association recommends that anyone diagnosed with type 2 diabetes also have thyroid testing at diagnosis, as well as regular follow-up testing.

The American Diabetes Council estimates that 10.8 percent of people with thyroid disease also have diabetes. The Diabetes Council also estimates that:

36 percent of people with hypothyroidism also has diabetes

12 percent of people with hyperthyroidism also has diabetes

11 percent of women with postpartum thyroiditis also has diabetes

If you have Hashimoto’s or Graves’ disease, you are more prone to developing type 1 diabetes.

Studies have also shown that for people with hypothyroidism, having a higher TSH level — even if you are being treated and your TSH falls within the reference range — puts you at a greater risk of developing type 2 diabetes.

Thyroid status and insulin treatment

If you are treating diabetes with insulin, thyroid disease can make it more difficult to manage your blood sugar levels.

Hyperthyroidism increases your metabolism and makes you metabolize medications more quickly. This includes insulin. If you are insulin-dependent, you may need a higher dose of insulin while hyperthyroid or overmedicated on thyroid hormone replacement medication. Otherwise, you are at risk of high blood sugar, known as hyperglycemia.

Hypothyroidism slows your metabolism and can slow the speed at which you metabolize medications. This includes insulin. If you are insulin-dependent, you may need lower doses, or you risk having low blood sugar, known as hypoglycemia.

Preventing type 2 diabetes

There are no proven ways to prevent type 1 diabetes. Type 2 diabetes, however, is preventable if you make changes that help you lower your blood sugar and increase your sensitivity to insulin. Some of the ways to accomplish these goals include the following:

Optimal thyroid treatment. This means careful control of hypothyroidism or hyperthyroidism. Optimal hypothyroidism control usually means a TSH level less than 2.5, and free T4 and free T3 levels in the upper half of the reference range.

Mary Shomon

Mary Shomon is a patient advocate and New York Times bestselling author who empowers readers with information on thyroid and autoimmune disease, diabetes, weight loss and hormonal health from an integrative perspective. Mary has been a leading force advocating for more effective, patient-centered hormonal healthcare. Mary also co-stars in PBS’ Healthy Hormones TV series.